Pelvic Pain

Question 1

Over 50% of IC patients were initially diagnosed with a ____

Answer 1

UTI

Question 2

OAB symptoms unresponsive to anti-cholinergic medications is pathognomic of ____

Answer 2

IC

Question 3

With ____, urgency is associated with fear of leakage

Answer 3

OAB

Question 4

With ___, urgency is associated with pain

Answer 4

IC

Question 5

IC/BPS Definition

An unpleasant sensation (pain, pressure / discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms >___ duration in the absence of infection or other identifiable causes

Answer 5

6 weeks

Question 6

1st line therapy for IC

Answer 6

Behaviorial modifications & stress reduction

Question 7

2nd line IC therapy + medications

Answer 7

pelvic floor physical therapy avoid pelvic floor strengthening exercises (i.e. Kegels)

Amitriptyline 25-50 mg qHS, cimetidine, hydroxyzine 10-25mg qHS, or pentosan polysulfate

Question 8

2nd line IC therapy with intravesical agents

Answer 8

DMSO, heparin, or lidocaine

Question 9

3rd line IC therapy with cystoscopic interventions

Answer 9

Hydrodistension, fulguration/steroid injection of Hunner’s lesions

Question 10

4th line IC therapy with devices & injections

Answer 10

Neuromodulation OR Botox injections

Question 11

Last line IC therapy with medication or surgery

Answer 11

Cyclosporine A, bladder diversion

Question 12

Only oral treatment approved by the US FDA for the relief of bladder pain or discomfort associated with interstitial cystitis

Answer 12

pentosan polysulfate

Question 13

Intravesical agent with adverse effect of Garlic-like taste/odor on breath/skin

Answer 13

DMSO

Question 14

Interstim Indications

Answer 14

Urgency/frequency unresponsive to medical therapy
Urge incontinence
Retention not caused by obstruction
Fecal incontinence

NOT IC or PELVIC PAIN

Question 15

Reflexes at S3

Answer 15

Toe extension & anal bellows